Gastroenterology

Acute Pancreatitis — Clinical Reference

Last reviewed 2026-06-19 · TruelyserMD Clinical Reference
For Patients & General Readers

Acute pancreatitis is a sudden inflammation of the pancreas, an organ that helps digest food. It's most often caused by gallstones or heavy alcohol use. This condition can cause severe abdominal pain and requires prompt medical attention to prevent serious complications.

Clinical Overview

Acute pancreatitis is a sudden inflammatory process of the pancreas characterized by premature activation of pancreatic enzymes within the gland, leading to autodigestion. Common etiologies include gallstones and alcohol abuse, with diagnosis relying on characteristic clinical presentation, elevated serum amylase and lipase levels, and characteristic imaging findings.

Clinical Presentation

Signs & Symptoms

Symptoms (Patient-Reported)

  • Severe upper abdominal pain
  • Pain that radiates to the back
  • Nausea
  • Vomiting
  • Abdominal tenderness
  • Fever

Signs (Clinician-Observed)

  • Epigastric tenderness
  • Abdominal distension
  • Diminished bowel sounds
  • Tachycardia
  • Hypotension (in severe cases)

Differential Diagnoses

ConditionDistinguishing Feature
Peptic Ulcer Disease (PUD)Pain may be burning, relieved by food or antacids, and less likely to radiate to the back. Amylase/lipase typically normal unless perforation occurs.
Cholecystitis/CholangitisPain is often in the right upper quadrant, associated with fever and jaundice. Ultrasound is key for gallbladder pathology. Pancreatic enzymes may be mildly elevated due to shared ductal system.
Bowel ObstructionPain is colicky, associated with distension, obstipation, and vomiting. Bowel sounds may be hyperactive initially then absent. Imaging shows dilated loops of bowel.
Myocardial Infarction (Inferior Wall)Pain can mimic epigastric pain, but ECG and cardiac biomarkers are diagnostic. Amylase/lipase are normal.
Aortic Aneurysm DissectionSudden, severe tearing chest or back pain. May have pulse deficits. CT angiography is diagnostic.
Gastritis/GastroenteritisPain is typically less severe and more diffuse, often associated with diarrhea. Pancreatic enzymes are normal.

Red Flags — Seek Immediate Care

Key Investigations

Management Overview

Management focuses on supportive care, including aggressive intravenous fluid resuscitation, pain control with analgesics, and nutritional support. Identifying and treating the underlying cause, such as cholecystectomy for gallstone pancreatitis, is crucial for preventing recurrence.

Disclaimer: This article is for educational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional for diagnosis and treatment. TruelyserMD does not replace clinical judgement.